How does this medication work? What will it do for me?

This medication is a combination product that contains two medications: ciprofloxacin and dexamethasone. Ciprofloxacin is an antibiotic that belongs to the family of medications known as fluoroquinolones. It is used for the treatment of infections caused by certain bacteria. Dexamethasone belongs to a family of medications known as corticosteroids. Corticosteroids reduce inflammation.

Ciprofloxacin - dexamethasone ear drops are used to treat bacterial middle ear infections in children 6 months and older who have tubes in their ears. They are also used to treat outer ear infections in anyone 1 year and older.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are using this medication, speak to your doctor. Do not stop using this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to use this medication if their doctor has not prescribed it.

What form(s) does this medication come in?

Each mL of otic suspension contains ciprofloxacin HCl (equivalent to ciprofloxacin base 3 mg) and dexamethasone 1 mg. Nonmedicinal ingredients: acetic acid, benzalkonium chloride as preservative, boric acid, edetate disodium, hydroxyethyl cellulose, purified water, sodium acetate, sodium chloride, and tyloxapol. Sodium hydroxide and/or hydrochloric acid may be added for adjustment of pH.

How should I use this medication?

The usual dose of this medication for both middle and outer ear infections is 4 drops into the affected ear twice a day (about 12 hours apart) for 7 days. The person giving or using the medication should wash their hands with soap and water first. To avoid dizziness, warm the ear drops in the palm of your hand for 1 to 2 minutes before using. Shake the bottle well immediately before using. The simplest way to put drops in the ear is to lie down with the affected ear up. Drop the medication directly into the ear. You or your child should remain in that position for 60 seconds so the drops don't leak out.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are using the medication without consulting your doctor.

Ask your doctor or pharmacist to show you the correct method of using ear drops. The procedure is different for children than for adults. The procedure also differs whether there are tubes in the ear or not. This medication is intended for use only as ear drops. Do not apply this medication to your eyes.

It is important to use this medication exactly as prescribed by your doctor. Continue using this medication for the period of time prescribed by your doctor, even if you start to feel better. Stopping the medication too early may cause the bacteria to return and be harder to treat. If there is no improvement in the infection after you have been using the medication for one week, contact your doctor.

If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature, protect it from light, and keep it out of the reach of children. After treatment has finished, safely discard any remaining drops in the dropper bottle. Do not keep any leftover medication for future use.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Who should NOT take this medication?

Do not use this medication if you:

  • are allergic to dexamethasone, ciprofloxacin, or any ingredients of the medication
  • are allergic to any of the medications belonging to the class of medications called quinolones (e.g., levofloxacin, moxifloxacin, ofloxacin, norfloxacin, nalidixic acid)
  • are allergic to any other corticosteroids (e.g., prednisone, hydrocortisone)
  • have viral infections of the external ear, including chicken pox and herpes simplex
  • have an ear infection caused by yeast, fungi, or parasites

What side effects are possible with this medication?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who uses this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people using this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

  • changes in taste
  • ear debris
  • ear discomfort (feeling of fullness or plugging in the ear)
  • ear itching
  • ear pain
  • irritability
  • overgrowth of fungus, yeast, or other bacteria in the affected ear

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

  • discharge from the ear
  • ear swelling
  • nausea
  • peeling skin
  • vomiting

Stop using the medication and seek immediate medical attention if any of the following occur:

  • signs of allergic reaction such as skin itching, rash, redness, or swelling

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are there any other precautions or warnings for this medication?

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Allergic reactions: Ciprofloxacin may cause a skin rash. If you notice skin rashes, skin blisters, itchy skin, hives, or other signs of an allergic reaction, stop using the medication and contact your doctor immediately.

Overgrowth of organisms: As with other antibiotics, treatment with this medication may allow normal fungus, yeast, or types of bacteria not killed by the antibiotic to overgrow, causing unwanted infections. If the infection is not improved after one week of therapy, contact your doctor.

Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: This medication may pass into breast milk. If you are a breast-feeding mother and are using ciprofloxacin - dexamethasone, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of this medication have not been established for children under 6 months old.

What other drugs could interact with this medication?

Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications that you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them. Depending on your specific circumstances, your doctor may want you to:

  • stop taking one of the medications,
  • change one of the medications to another,
  • change how you are taking one or both of the medications, or
  • leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. In many cases, interactions are intended or are managed by close monitoring. Speak to your doctor about how any drug interactions are being managed or should be managed.

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